Technology can’t solve health care problems-health care blog
Shira Ovide, who wrote the On Tech newsletter New York Times, There was a thoughtful column last week: Technology can’t solve the car’s problems. She said it was inspired by Peter Norton Autonorama: The fantasy promise of high-tech driving. The premise of the two is that if the title has not been given up, putting more technology into our cars will not solve the potential problems caused by the car.
This reminds me of healthcare.
What has happened in the automotive industry over the past decade is truly amazing. Our cars have become mobile screens, equipped with large dashboard touchscreen displays, Bluetooth and streaming media. Electric vehicles have gone from an expensive pipe dream to an agreed future. Although Tesla has never sold 500,000 vehicles per year before 2021, its value is more than $1 trillion.
If we don’t want to drive, we can call Uber or Lyft using our smartphones. Or, we can use the various automatic driving functions that are already on many cars, hoping that a fully autonomous car is right in front of us. It seems that soon, we will have pollution-free self-driving cars on standby: fewer deaths/injuries, less pollution, and fewer vehicles that are idle for most of the day. Utopia, right?
This is what Ms. Ovid and Dr. Norton questioned. Ms. Ovid said: “There is also a risk that focusing our attention on these technological miracles may prevent us from facing deeper questions: How can we make our lives less dependent on cars?”
Their argument is that making getting in the car cheaper, safer, and more convenient will most likely only allow us to drive more miles (just like adding/expanding a highway) proved To induce demand instead of alleviating congestion).
Ms. Ovid described some of Dr. Norton’s arguments:
But Dr. Norton also said that it would be useful to shift funding and attention to more affordable and attractive options for walking, biking, and using shared transportation.
Dr. Norton asked us to imagine what would happen if a small fraction of the crazy dollars used to develop driverless cars were invested in unfancy products and policy changes.
She concluded: “We know that technology can improve our lives. But we also know that belief in the future of technology can sometimes prevent us from facing the root of the problem.”
The same is true for healthcare.
Funds are flowing into the digital health field in a way that makes the real estate market look rational. Every day there are new investment rounds to value digital health companies that you have never heard of, and few of us can distinguish them, worth hundreds of millions of dollars. It must be believed that healthcare will be more digital; we don’t know exactly how or when, but all bets are covered more safely.
At the same time, large-scale healthcare systems and large-scale healthcare payers are becoming larger and larger, each of them devouring competitors and entrants based on new technologies in a way recognized by large technology companies. Today, if you are in the healthcare industry and someone does not acquire or invest in you, you are doing it wrong.
However, as people have pointed out to cars, technology will not solve many of the problems faced by healthcare. As Nick van Terheyden, MD, said on Twitter last week:
If you work in the healthcare field, you will know the systemic problems he is referring to. If you have ever received medical care, or know anyone who has received medical care, you may have seen some of them. If you have the “wrong” insurance status, gender, race/ethnicity, or location, you have undoubtedly experienced it.
To call our healthcare system a “system” is an exaggeration; it does not work like a system. For many people, it doesn’t work at all. It evolved from something smaller and simpler, and, just like evolution in general, it has many miscellaneous things that have no obvious or useful purpose. After all, the goal of evolution is to survive to the next generation, not efficiency, elegance or fairness.
Recently, Rasu Shrestha, MD, lead Geoffrey Rose, MD of Atrium Health: “A system that needs a navigator is a system that needs to be redesigned.” What we do in the healthcare field is to add more and more navigators, especially technology-based navigators, instead of Redesign the system.
We can add all the technology and healthcare we want should Having more and better technology-but this does not necessarily mean that people without insurance (or low-payment insurance such as Medicaid) will get the same care. We can apply artificial intelligence and big data to many health care problems, but unless we are very careful and very purposeful, this does not mean that women or people of color will receive the same care as white men and receive the same result. We can build many beautiful new buildings, but this does not mean that the quality of care of these buildings will be the same as the quality of the best care.
Even if we provide everyone with all the medical care we can provide, this does not mean that our health will be/possible. If our healthcare system continues to ignore one lesson, then medicine is different from health. The familiar SDoH chart now shows that only about 20% of health comes from the medical care we receive.
Dr. Norton wants us to invest in “unpretentious product and policy changes”, such as zoning changes that encourage us to walk more instead of driving. Compared with most of our health care expenditures, similar unpretentious products and policy changes will bring us greater benefits. How can we eat better, exercise more, drink cleaner water and air, etc.?
We built our city around cars—and our suburbs and interstate highways (not to mention our parking lots!). Our lifestyle depends on easy access to them. We will see electric cars, self-driving cars, and on-demand cars, but unless we rethink our basic attitude towards driving, we will not achieve the results we want.
The same is true for healthcare. I love technology as much as anyone and I am excited about how new technologies can be applied to healthcare, but let us be clear: technology alone cannot solve the basic problems of our healthcare system.
Kim was the former head of e-marketing of the main Blues project and the late editor Tincture, Is now a regular THCB contributor.